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Definition of low-value care in a low-risk preoperative population: A scoping review.
F John, Josiane; B S Etges, Ana Paula; A Z Marcolino, Miriam; D Urman, Richard; Marques-Gomes, João; A Polanczyk, Carisi.
Afiliação
  • F John J; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Brazil.
  • B S Etges AP; Graduate Program in Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • A Z Marcolino M; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Brazil.
  • D Urman R; School of Technology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
  • Marques-Gomes J; Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • A Polanczyk C; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Brazil.
J Eval Clin Pract ; 29(4): 639-646, 2023 06.
Article em En | MEDLINE | ID: mdl-36779241
RATIONALE: Preoperative care is one of the main areas in which to address low-value care. A detailed definition of what low-value care is in this period of the surgical care journey paves the way for new scientific research, clinical improvements, and reduction of unnecessary costs in this field. AIMS AND OBJECTIVE: To identify how low-value care in low-risk preoperative population has been defined in the scientific literature and propose a low-value care framework with potential consequences in this setting. METHODS: Scoping review of theoretical studies and peer-reviewed papers, including reviews, commentaries, or expert opinions, were considered eligible for inclusion. The following databases were consulted: MEDLINE (via PubMed), EMBASE, and SCOPUS (from inception to July 24, 2021), using a structured search with the keywords "low value care", "clinical waste", "preoperative", and "elective procedures." Two independent reviewers performed study selection and data extraction. The definition of low-value care in the preoperative period and their consequences were described after extracting previous low-value care concepts and summarising the contents. Also, a visual framework was built with this information. RESULTS: From 1519 publications identified in the initial searches, 22 underwent full-text assessment, and 11 conceptual studies were included in the review. A total of four studies (36%) presented a general low-value care definition, and all studies report some situations considered low-value care in the preoperative field of low-risk surgeries. The most common example of preoperative low-value care, listed in nine studies (81%), was having asymptomatic patients undergo screening tests before surgery. The main clinical and nonclinical consequences of low-value care in the preoperative phase included false-positive results from exams as well as psychological distress, increased costs, and delay in surgery. CONCLUSIONS: Revisiting and integrating previous definitions of low-value care in low-risk surgery into a scoping review is a starting point for de-implementing unnecessary care and promoting improvements in surgical pathways.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pré-Operatórios / Cuidados de Baixo Valor Tipo de estudo: Etiology_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Eval Clin Pract Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pré-Operatórios / Cuidados de Baixo Valor Tipo de estudo: Etiology_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Eval Clin Pract Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido